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Public Health and Sex Work: Using History to Motivate Change. 公共卫生和性工作:用历史激励变革。
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2021-01-01 DOI: 10.1080/01947648.2021.1935633
Brittney M Welch
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引用次数: 0
The History and Policy Evolution of Waivers of Informed Consent in Research. 研究中放弃知情同意的历史与政策演变。
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2021-01-01 DOI: 10.1080/01947648.2021.1917464
Austin Connor Kassels, Jon F Merz

We examine the evolution of policies permitting exceptions to or waivers of informed consent for research in the United States. This review reveals that (1) exceptions to the duty to secure informed consent were originally quite narrow; (2) there were two alternative approaches to allowing research on human subjects without their prospective consent: (i) exceptions in which individual capacity to consent is to be assessed and consent tailored to each person's abilities and (ii) waivers of the general requirement for a population of potential subjects, where securing prospective consent would "destroy or invalidate" critically important research; (3) waivers only appeared in the final rulemakings for research regulations issued by the National Institute of Education in 1974 and the Department of Health and Human Services in 1981, limiting the opportunity for the public to weigh in on the scope and use of waivers; and (4) rules adopted since 1981 have almost uniformly added extra requirements to justify waivers. Examples drawn from recent research show expansion of the use of waivers far beyond the bounds originally envisioned. Greater transparency about the use of waivers is needed for the public to weigh in on the standards for foregoing informed consent in human research.

我们研究了在美国允许例外或放弃知情同意研究的政策的演变。这一审查表明:(1)确保知情同意义务的例外最初是相当狭窄的;(2)允许对人体受试者进行未经其事先同意的研究有两种可供选择的方法:(i)对个人同意能力进行评估的例外情况,并根据每个人的能力量身定制同意;(ii)对潜在受试者群体的一般要求的豁免,在这种情况下,获得事先同意将“破坏或无效”至关重要的研究;(3)豁免只出现在1974年国家教育研究所和1981年卫生与公众服务部发布的研究条例的最终规则制定中,限制了公众对豁免的范围和使用进行权衡的机会;(4)自1981年以来采用的规则几乎一致地增加了额外的要求来证明豁免的合理性。从最近的研究中得出的例子表明,豁免的使用范围远远超出了最初设想的范围。为了让公众对人类研究中前述知情同意的标准进行权衡,需要提高豁免使用的透明度。
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引用次数: 4
Exposed: Why Health Insurance Is Incomplete and What Can Be Done about It: Christopher T. Robertson (Harvard University Press, 2019, 248 pp.) 暴露:为什么健康保险是不完整的,可以做些什么:克里斯托弗·罗伯逊(哈佛大学出版社,2019年,248页)
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-11-02 DOI: 10.1080/01947648.2020.1826875
Isaac D. Buck Reviewed by
Health law and policy scholars are naturally motivated to improve the American health care system, which is defined by poor quality metrics, racial and socioeconomic disparities, and exorbitant cos...
健康法律和政策学者自然有动力改善美国的医疗保健系统,这是由质量指标差,种族和社会经济差异,以及过高的成本所定义的。
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引用次数: 0
The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America 《万亿美元革命:平价医疗法案如何改变美国的政治、法律和医疗保健》
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-10-01 DOI: 10.1080/01947648.2020.1856568
Erin C Fuse Brown
In the midst of an historic election, with the Supreme Court considering another existential challenge to the Affordable Care Act (ACA) and with the nation plunged into a public health and economic crisis from the 2020 coronavirus pandemic, the ACA is as important as ever. The ACA matters. It matters to many millions who count on its protections to access health coverage, particularly as they lose their job-based insurance in the pandemic. It matters to voters and to their representatives tasked with the next generation of health reform. It matters to states, the health care industry, and businesses who have sunk innumerable resources and time into making the ACA work. The Trillion Dollar Revolution assesses the ACA at 10 years, marking its achievements, trade-offs, shortfalls, impacts, and lessons for future reforms. The ACA was both monumental and paradoxical. It was the single biggest social welfare legislation enacted in 50 years and touched every aspect of our sprawling health care system. Yet the narrow political window for its passage meant that the ACA was incremental, building on, rather than fundamentally restructuring, our fragmented health care system. The ACA was imperfect because it inherited many flaws of the existing health care system. Nevertheless, the ACA achieved something quite revolutionary—it changed the minds of the American public, who have since embraced notions of health care access as a right and preexisting condition protections as a given. Edited by Ezekiel Emanuel and Abbe Gluck, the book reads like an insider’s account and assessment of the ACA. The contributors are a veritable Who’s Who of lawyers, health law scholars, health economists, health policy experts, and political leaders with a front-row view of the ACA. Divided into five parts, the essays discuss the ACA’s (I) policy goals, (II) implementation, (III) legal challenges, (IV) impacts, and (V) lessons for the future. The book is well suited for health law and policy students in college or graduatelevel courses, as well as for academics, journalists, health policymakers, and wonks. Fittingly, the book opens with a chapter by Timothy Stoltzfus Jost and John McDonough, perhaps the two most knowledgeable individuals in the country about the law and policy of the ACA. This chapter could stand by itself for its concise history of the ACA, what drove it, what it did, what worked, and what it did not do. Historians and policy scholars will appreciate the first-person accounts of the difficult trade-offs in passage and challenges of implementation by those who were in the room where it happened, including Kathleen Sebelius, who was the Secretary of Health & Human Services for the passage and implementation; Nancy-Ann DePearle, senior health policy advisor to President Obama; Peter Orszag, the director of the Office of
在一场历史性的选举中,最高法院正在考虑对《平价医疗法案》(ACA)的又一次生死存亡的挑战,以及美国因2020年冠状病毒大流行而陷入公共卫生和经济危机,ACA与以往一样重要。ACA很重要。这对数百万依靠其保护获得医疗保险的人至关重要,特别是在大流行期间他们失去了以工作为基础的保险。这对选民和他们负责下一代医疗改革的代表很重要。这对各州、医疗保健行业和企业都很重要,他们已经投入了无数的资源和时间来实施《平价医疗法案》。《万亿美元革命》对ACA进行了10年的评估,对其成就、利弊、不足、影响和未来改革的教训进行了评估。ACA既具有里程碑意义,又自相矛盾。这是50年来颁布的最大的一项社会福利立法,触及了我们庞大的医疗体系的方方面面。然而,它通过的政治窗口很窄,这意味着ACA是渐进式的,是建立在我们支离破碎的医疗体系之上的,而不是从根本上重组。ACA并不完美,因为它继承了现有医疗体系的许多缺陷。尽管如此,《平价医疗法案》还是取得了一些革命性的成就——它改变了美国公众的观念,从那时起,他们就把获得医疗保健作为一种权利,把保护已存在的疾病作为一种既定的概念。这本书由伊曼纽尔(Ezekiel Emanuel)和格拉克(Abbe Gluck)编辑,读起来像是一位内部人士对ACA的描述和评估。这些撰稿人是名副其实的名人录,包括律师、卫生法学者、卫生经济学家、卫生政策专家和对ACA有第一手了解的政治领导人。文章分为五个部分,讨论ACA的(I)政策目标,(II)实施,(III)法律挑战,(IV)影响,以及(V)未来的教训。这本书是非常适合卫生法律和政策的学生在大学或研究生水平的课程,以及学者,记者,卫生政策制定者和工作。这本书恰当地以蒂莫西·斯托尔茨弗斯·约斯特和约翰·麦克多诺的一章开篇,他们也许是这个国家对《平价医疗法案》的法律和政策最了解的两个人。本章对ACA的历史进行了简明扼要的介绍,包括推动ACA的因素、它做了什么、什么起了作用、什么没有起作用。历史学家和政策学者将会欣赏那些当时在场的人对法案通过过程中的艰难权衡和实施过程中的挑战的第一人称描述,其中包括负责法案通过和实施的卫生与公众服务部部长凯瑟琳·西贝利厄斯(Kathleen Sebelius);奥巴马总统的高级卫生政策顾问Nancy-Ann DePearle;彼得·奥斯泽格是
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引用次数: 3
Preventing Child Trafficking: A Public Health Approach 防止贩卖儿童:一种公共卫生办法
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-10-01 DOI: 10.1080/01947648.2020.1856567
A. English
Preventing Child Trafficking: A Public Health Approach, published in 2019, is written by two experts on human trafficking of children: Jonathan Todres, Distinguished University Professor at Georgia State University College of Law, and Angela Diaz, professor of adolescent health at the Icahn School of Medicine and director of the Mount Sinai Adolescent Health Center in New York City. Since the book’s publication, the world has changed dramatically, with the emergence in 2020 of the COVID-19 pandemic and the increased visibility of rampant, systemic racism. These developments underscore the importance of the central message of Preventing Child Trafficking—that prevention must be prioritized in addressing human trafficking of children and that a public health approach is essential in doing so. The authors make their case methodically, with a detailed review of laws, policies, and programs; careful attention to the burgeoning body of relevant evidence; and useful real-life illustrations drawn from their extensive experience with children and adolescents who have been trafficked. At the outset, Todres and Diaz provide useful discussion of terminology, definitions, and the focus of the book. This discussion highlights important issues. For example, use of the word “child” in the title and throughout the book has both advantages and drawbacks. Its use is consistent with terminology in international treaties, U.S. laws, and many official policies and reports. In that context, it refers to individuals under the age of 18 years. This usage is also reflected in a growing concern about exploitation of “children,” not only among policymakers but also on the part of the public. At the same time, as the authors acknowledge, the 18th birthday is often irrelevant when examining who is trafficked. The reality is that many “adolescents,” “youth,” and “young adults” who are over the age of 18 are trafficked and exploited in the same ways as younger children and adolescents who not yet age 18. Even though the terminology does not correspond to legal definitions, addressing the needs of these age groups is just as important when implementing a public health approach to trafficking. The focus of Preventing Child Trafficking, as the authors explain, is primarily on sex trafficking. This foregoes an opportunity to do a deeper exploration of the intersection of sex and labor trafficking and of public health implications and potential with respect to labor trafficking. Addressing forced labor and labor trafficking is an essential component of an effective public health approach to trafficking for several reasons. The risk factors and root causes are similar to those of sex trafficking, and the adverse health consequences are also similar in both nature and severity. The authors acknowledge this and do a good job of highlighting the specific ways in which human trafficking touches all of us—in the clothes and other products we buy, the food we eat—many of which involve forc
《预防拐卖儿童:一种公共卫生方法》于2019年出版,由两位儿童拐卖问题专家撰写:乔治亚州立大学法学院杰出大学教授乔纳森·托德雷斯和伊坎医学院青少年健康教授、纽约市西奈山青少年健康中心主任安吉拉·迪亚兹。自这本书出版以来,世界发生了巨大变化,2020年出现了COVID-19大流行,猖獗的系统性种族主义越来越明显。这些事态发展突出了《防止贩运儿童》的中心信息的重要性,即在处理人口贩运儿童问题时必须优先考虑预防问题,为此必须采取公共卫生措施。作者通过对法律、政策和项目的详细回顾,有条不紊地阐述了他们的观点;仔细关注不断涌现的相关证据;以及从他们与被拐卖的儿童和青少年打交道的丰富经验中得出的有用的真实例子。一开始,Todres和Diaz就术语、定义和本书的重点进行了有益的讨论。这次讨论突出了一些重要问题。例如,在标题和全书中使用“孩子”一词既有优点也有缺点。它的用法与国际条约、美国法律以及许多官方政策和报告中的术语一致。在这方面,它指的是18岁以下的个人。这种用法也反映在决策者和公众对剥削“儿童”的日益关注上。与此同时,正如作者所承认的那样,在调查谁被拐卖时,18岁生日往往是无关紧要的。现实情况是,许多18岁以上的“青少年”和“年轻人”被贩卖和剥削的方式与年龄更小的儿童和未满18岁的青少年一样。尽管这些术语不符合法律定义,但在对贩运问题采取公共卫生办法时,满足这些年龄组的需求同样重要。正如作者解释的那样,《防止拐卖儿童》的重点主要是性交易。这就放弃了深入探讨性与劳工贩运的相互关系以及劳工贩运对公共卫生的影响和潜力的机会。处理强迫劳动和贩运劳工问题是打击贩运人口的有效公共卫生办法的一个重要组成部分,原因如下。风险因素和根本原因与性贩运的风险因素和根本原因相似,对健康造成的不良后果在性质和严重程度上也相似。作者承认这一点,并很好地强调了人口贩运影响我们所有人的具体方式——我们购买的衣服和其他产品,我们吃的食物——其中许多涉及强迫劳动或劳动力贩运。他们的定位
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引用次数: 0
Abortion and the Law in America: Roe v. Wade to the Present 美国的堕胎与法律:罗伊诉韦德案至今
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-10-01 DOI: 10.1080/01947648.2020.1856569
E. Segall
Professor Mary Ziegler is the author of three books on abortion. Her latest book, Abortion and the Law in America: Roe v. Wade to the Present, like the first two, makes major contributions to the unfortunately divisive debates about women’s right to control their reproductive choices and the concerns of millions of Americans for the fetuses killed when women exercise those rights. Readers will not uncover Ziegler’s personal views on abortion when reading this book, which is just one of the many strengths of this wonderful new treatment of a very old topic. Talking about abortion is truly difficult in our polarized country. I once wrote the following:
玛丽·齐格勒教授是三本关于堕胎的书的作者。她的新书《美国的堕胎与法律:罗伊诉韦德案至今》和前两本书一样,对关于女性控制生育选择的权利以及数百万美国人对女性行使这些权利时胎儿死亡的担忧的不幸分歧辩论做出了重大贡献。读者在阅读这本书时不会发现齐格勒对堕胎的个人观点,这只是这本对一个非常古老的话题进行了精彩的新处理的众多优点之一。在我们这个两极化的国家,谈论堕胎真的很困难。我曾经这样写道:
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引用次数: 11
Investigating the Relationship Between Opioid Prescription Frequency and Deaths from Illicit Opioids 阿片类药物处方频率与非法阿片类药物死亡的关系研究
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-08-28 DOI: 10.1080/01947648.2020.1833656
L. Price, Sarah E. Fagan, Joseph P. Hardy
In response to the large number of opioid prescriptions and the perceived opioid crisis, numerous states, including Nevada, responded by imposing mandates on physicians’ prescribing practices for t...
为了应对大量的阿片类药物处方和感知到的阿片类药物危机,包括内华达州在内的许多州通过对医生的处方实践实施强制性规定来应对…
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引用次数: 0
The Ethical Issues of Healthcare Insurance Coverage 医疗保险覆盖的伦理问题
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-08-28 DOI: 10.1080/01947648.2020.1833669
T. Green, J. Demay, Tabitha Sierra, K. Zucker, C. Unsworth
Health insurance is complex and greatly affects healthcare delivery in the United States. Risk pooling and limited resources create ethical challenges on how to distribute care and determine covere...
健康保险是复杂的,极大地影响了美国的医疗保健服务。风险分担和有限的资源给如何分配医疗服务和确定覆盖范围带来了伦理挑战。
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引用次数: 0
Is the Collection and Distribution of Abortion Providers’ Names and Addresses a Solicitation for Violence? 收集和分发堕胎提供者的姓名和地址是否构成煽动暴力?
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-08-28 DOI: 10.1080/01947648.2020.1833671
M. DeSanto, A. M. Weaver, R. Bitonte
In the midst of the technological age, many groups have found another platform to express their voice and beliefs through the internet. Many individuals also look to the internet to research health...
在科技时代,许多群体通过互联网找到了另一个表达自己声音和信仰的平台。许多人还通过互联网研究健康……
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引用次数: 0
Class Action Litigation: an Effective Tool for Public Health Issues; Specifically Vaping and Electronic Cigarettes 集体诉讼:解决公共卫生问题的有效工具特别是电子烟和电子烟
IF 0.4 4区 医学 Q2 Social Sciences Pub Date : 2020-08-28 DOI: 10.1080/01947648.2020.1833660
M. G. Harris, R. Bitonte
Vaping was once thought of as a healthier alternative to smoking cigarettes in that the user is not inhaling burned tobacco but instead inhaling an aerosol. The vape liquid is also noted to have le...
电子烟曾被认为是一种比吸烟更健康的替代品,因为使用者吸入的不是烧焦的烟草,而是气溶胶。电子烟液体也被认为含有…
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引用次数: 0
期刊
Journal of Legal Medicine
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